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Dr. Mark, Psychotherapist

Category: Mental Health

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Experience: Dr. Mark is a PhD in psychology in private practice

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Fear of schizophrenia?? advice please?
So I have been a bad

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Fear of schizophrenia?? advice please?So I have been a bad hypochondriac ever since I was little. I remember as early as 6 worrying about diseases I could have. I have really intrusive thoughts about going crazy or losing my mind. I have the Obsession part of OCD. Anyway I'm 21 now and can't seem to shake this fear of developing schizophrenia. I keep analyzing all my thoughts and behaviors and keep thinking eventually I'll get schizo. Also I have insomnia and don't sleep well and that has me worrying that my poor sleep will lead to me developing this disease too. Am I going to get this illness from worrying and poor sleep? I am already 21 so wouldn't the symptoms have poked its head out by now especially since I am a male. Also I don't have this illness in my family, just think all this worry will trigger it. Any advice would be much appreciated!

First, let me say I can imagine how frustrating, distressing, and worrisome this situation must be for you. You are aware that you are dealing here with symptoms of an OCD type problem. It is mild and that's good. I know you don't think it's mild, it doesn't feel mild. But in my practice as a psychologist these obsessive symptoms are relatively mild. That's good.

Second, you are clearly an intelligent young man. You've learned quite a bit about both obsessive thought and schizophrenia (SZ). You know that SZ is often linked to genetic predispositions in families. And you gave me the essential information we needed to know: that you do not have this genetic predisposition. Good for you, that was important information.

Given this good news, I want to reassure you very strongly that SZ is not contracted by worries, obsessive thinking, or anxiety. I've worked on teams as the psychotherapist with patients suffering from SZ. Obsessive thinking can be a symptom for people with SZ but it is not even among the main symptoms we look for in diagnosing and treating. It can be associated with SZ but is not a primary symptom. And it certainly is not a cause.

Okay. But we still want to try to deal with the obsessive thinking about mental illness and SZ specifically. You sense in yourself that you are CONVICING yourself of something that has no reality other than your inability to stop thinking about it and obsessing about it. It's a vicious cycle that is caused by anxiety and increases anxiety. You originally started feeling anxiety because of some triggering event that is now long forgotten and may have been not a big deal even then, but now the anxiety has settled in to become itself the problem rather than a reaction to a problem. At the end of this posting I’m going to include a technique to use when the anxiety from these thoughts and worries rises. It will give you a little relief so you can use some of the other techniques I will be talking to you about.

You need to know that this is not as uncommon as you think. Intelligent people, both male and female, tend to have these obsessive thoughts. And there is no way to predict or know why each person's subconscious mind chooses one thing to obsess about instead of another. Your mind fastened on SZ and losing your mind. These are not anything profoundly true, they are just what your mind fastened on. Other people fasten on other things. We can theorize about fears driving the subconscious choice of subject, but it's only theorizing at this time. Therefore, I need you to reorient your view of what is going on.

EVERYONE has strange thoughts come into our minds! So what's the difference between all of us and those who have a psychological problem? What we DO with those strange thoughts.

Here's what I mean:

It is very common to have a thought about jumping or falling off a subway platform or onto the tracks of a train. Why? Because we've all seen images of this in movies, etc. Same with jumping off balconies or falling. And other such calamities. BUT, most of us let these thoughts just go. We don't hold on to them. We treat them like all the other type of fleeting thoughts we have throughout the day about whole sorts of things. We just let them go and don't attach any importance to them. When someone CAN'T let the thought go, then that could be part of Obsessive Compulsive Disorder for example, or some other anxiety disorder.

Do you see the difference here? It's not in the thought. It's in what we do with it. So for some reason you don't know about, the obsessive thoughts of SZ and losing your mind are now habitually coming into your mind. But that's all they are: habit.

By the way, you may be interested: about 14 months ago I treated in my private practice someone with stray thoughts problems. His tended toward being very sad about possible hidden motives in his thoughts. He was obsessed that if he thought about a relative in a fond way that really he must have had a malevolent intent: that somehow by thinking a pleasant thought about his mom, dad, or someone else, he was actually hoping they would get cancer or something like that. It was very debilitating to him. He thought he might lose his mind from this type of thinking. What did we work on? What I'm telling you. We worked on changing his view from being so scared of these thoughts to just letting these stray strange thoughts go the way of any other fleeting thought.

So, that is the key and I hope you will be able to apply it on your own or with help in therapy. Apply the strategy. Every time you have the thought, consciously tell yourself that it is just a stray thought, a strange thought. This is just a stray thought. If it persists, use the technique below and remind yourself it's just a stray thought like everyone has because you still have residual anxiety. Got the technique?

Good. Here's the other part:

We're going to create an acronym. An acronym in case you don't know is when you take the first letters of something. Like EU stands for European Union, right? But whenever you hear or read EU, you know what it means. That's an acronym. So what's our acronym?

This is just a stray thought = TIJAST

When a thought of SZ and losing your mind wanders in you're going to remember TIJAST. But you also are going to remember what TIJAST stands for, okay?

And whenever you get nervous about it and start to worry, you're going to smile and say TIJAST! Because it is a funny word isn't it? TIJAST...this is just a stray thought...

Because we ALL get stray thoughts. The thoughts of suffering themselves have no power and are not a problem. It's the nervousness and fear you feel about having them that causes you a problem. So use the technique: It's only fear, it's not anything else. It's just fear of stray thoughts. It's..........TIJAST.

I also want you to commit yourself to apply the principles in the following videos and books to your worries about anxiety as you're a young man and need to move forward. So that you can be yourself with more confidence. Coach yourself. Be your own life coach! I want you to get really into motivational videos and books. In other words, accept your past fears, accept your past worries and hurts and traumas. Accept them and focus on becoming who you WANT to be now.Here's a simple YouTube search I put together on "motivational speakers":

Some like Tony Robbins are the classic big guys. Some are newer. There are now great women speakers as well. Watch them all. Get inspired. Buy a book or two. Here are some possibilities, but they are only suggestions as there are so many good ones.

The first book is the father of all these type of books. How to Win Friends and Influence People by Dale Carnegie. There are classes in these books now! It was written in the 1930s and still has something to say to us today that is very worthwhile.

I think very highly of the second book on my list, which is a real classic: The Seven Habits of Highly Effective People by Stephen Covey. It is the book that has helped more people than probably any other.

The third book is by Anthony Robbins. He's one of those speakers who fills up huge auditoriums. For a reason. He's a terrific speaker and writer. The particular book (if you like it, try his others): Awaken the Giant Within.

You can find all of these books easily on the internet with little investment. I wish you the very best!

I wish you the very best!

Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from anxiety and stray thoughts, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety from stray thoughts is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

INSTRUCTIONS:

After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.

Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.

Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.

Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.

Continue down your body, repeating the procedure with the following muscle groups:

chest

abdomen

entire right arm

right forearm and hand (making a fist)

right hand

entire left arm

left forearm and hand (again, making a fist)

left hand

buttocks

entire right leg

lower right leg and foot

right foot

entire left leg

lower left leg and foot

left foot

for the shortened version, which includes just four main muscle groups:

face

neck, shoulders and arms

abdomen and chest

buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

A comfortable place.

Some privacy.

A few minutes.

Again:

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Wow you gave very informative and a very thorough answer. I appreciate the time you gave my question. I am going to start practicing what you said as far as the TIJAST. It's simple but I can see how using this approach could be effective in keeping the intrusive thoughts away. My last question to you is, is my insomnia and lack of sleep going to pose a problem? As in could this have the potential to trigger SZ? I'm just trying to wrap my head around all of this.

No, it would not cause SZ as we understand that disorder today. That disorder is a brain disorder. Sleep deprivation can cause a psychotic episode in a person. However, the treatment would include hydration through IVs in a hospital and strong medications to get you sleeping and back to functional state. Then in an outpatient setting you would go through CBT therapy for anxiety and medications for sleeping. So the idea here is to use CBT before you get to such a sleep deprived state. That would be my hope for you. Because you're a young man who needs to work on this. I'm so glad you can see how TIJAST would work for you and hope you will be disciplined to use it in a continual way. And also please consider finding someone who is very experienced in OCD type problems and work with that person to help yourself overcome this. The psychological literature is very conclusive that CBT therapy specific to OCD type problems by an experienced trained psychologist is the most effective way to deal with it along with medications.

I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

I will tell you that...the things you have to go through to be an Expert are quite rigorous.

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